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Difference in insulin usage patterns with pubertal development in children with type 1 diabetes during transition

B Shashaj1, N Sulli

  • 1Department of Pediatrics, Diabetes Center, University of Rome La Sapienza, Rome, Italy. shblegina@hotmail.com

Diabetes Technology & Therapeutics
|December 17, 2009
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) significantly reduces insulin needs in children with type 1 diabetes. Insulin requirements and basal rate profiles vary by pubertal stage in pediatric patients on CSII.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes (T1D) management in pediatric patients requires careful insulin titration.
  • Transitioning from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) is a common strategy.
  • Understanding age-related differences in insulin needs is crucial for optimizing CSII therapy.

Purpose of the Study:

  • To analyze changes in insulin requirements during the MDI to CSII transition in pediatric T1D patients.
  • To investigate differences in insulin usage patterns and glycemic control among prepubertal, pubertal, and postpubertal patients on CSII.

Main Methods:

  • A longitudinal retrospective study of 40 pediatric T1D patients on CSII for 12 months.
  • Patients were stratified into three groups based on Tanner pubertal stages: prepubertal (Stage I), pubertal (Stages II-IV), and postpubertal (Stage V).
  • Insulin usage, basal rate profiles, and bolus patterns were analyzed across groups.

Main Results:

  • Insulin requirements decreased by 21% during the MDI to CSII transition.
  • Basal insulin constituted 52-60% of total daily insulin across all groups.
  • Significant differences were observed in basal rate timing and bolus frequency based on pubertal development, with higher basal rate complexity in younger groups and more "extra" boluses in older groups.

Conclusions:

  • Age-related variations in insulin needs and usage patterns exist in pediatric patients treated with CSII.
  • Tailoring CSII therapy based on pubertal stage can optimize glycemic control and treatment outcomes.
  • Further understanding of these differences can enhance the effectiveness of CSII in pediatric populations.
Abstract

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